Provider Demographics
NPI:1679642920
Name:OASIS FAMILY PRACTICE PC
Entity Type:Organization
Organization Name:OASIS FAMILY PRACTICE PC
Other - Org Name:OASIS FAMILY MEDICINE PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-329-9144
Mailing Address - Street 1:101 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4630
Mailing Address - Country:US
Mailing Address - Phone:303-329-9144
Mailing Address - Fax:
Practice Address - Street 1:101 UNIVERSITY BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4630
Practice Address - Country:US
Practice Address - Phone:303-329-9144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO439138Medicare UPIN